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Selected AbstractsComparison of the Heavy Metal Biosorption Capacity of Active, Heat-Inactivated and NaOH-Treated Phanerochaete chrysosporium BiosorbentsENGINEERING IN LIFE SCIENCES (ELECTRONIC), Issue 1 2004E. Güri Abstract Three different kinds of Phanerochaete chrysosporium (NaOH-treated, heat-inactivated and active) biosorbent were used for the removal of Cd(II) and Hg(II) ions from aquatic systems. The biosorption of Cd(II) and Hg(II) ions on three different forms of Phanerochaete chrysosporium was studied in aqueous solutions in the concentration range of 50,700 mg/L. Maximum biosorption capacities of NaOH-treated, heat-inactivated and active Phanerochaete chrysosporium biomass were found to be 148.37,mg/g, 78.68,mg/g and 68.56,mg/g for Cd(II) as well as 224.67,mg/g, 122.37,mg/g and 88.26,mg/g for Hg(II), respectively. For Cd(II) and Hg(II) ions, the order of affinity of the biosorbents was arranged as NaOH-treated,> heat-inactivated,>,active. The order of the amount of metal ions adsorbed was established as Hg(II),>,Cd(II) on a weight basis, and as Cd(II),>,Hg(II) on a molar basis. Biosorption equilibriums were established in about 60,min. The effect of the pH was also investigated, and maximum rates of biosorption of metal ions on the three different forms of Phanerochaete chrysosporium were observed at pH,6.0. The reusability experiments and synthetic wastewater studies were carried out with the most effective form, i.e., the NaOH-treated Phanerochaete chrysosporium biomass. It was observed that the biosorbent could be regenerated using 10,mM HCl solution, with a recovery of up to 98%, and it could be reused in five biosorption-desorption cycles without any considerable loss in biosorption capacity. The alkali-treated Phanerochaete chrysosporium removed 73% of Cd(II) and 81% of Hg(II) ions from synthetic wastewater. [source] Lack of evidence of the effectiveness of primary brachial plexus surgery for infants (under the age of two years) diagnosed with obstetric brachial plexus palsyINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2006Andrea Bialocerkowski PhD M App Sc (Physio) M App Sc (Physio) Grad Dip Public Health Abstract Background, Obstetric brachial plexus palsy, which occurs in 1,3 per 1000 live births, results from traction and/or compression of the brachial plexus in utero, during descent through the birth canal or during delivery. This results in a spectrum of injuries that range in extent of damage and severity and can lead to a lifelong impairment and functional difficulties associated with the use of the affected upper limb. Most infants diagnosed with obstetric brachial plexus palsy receive treatment, such as surgery to the brachial plexus, physiotherapy or occupational therapy, within the first months of life. However, there is controversy regarding the most effective form of management. This review follows on from our previous systematic review which investigated the effectiveness of primary conservative management in infants with obstetric brachial plexus palsy. This systematic review focuses on the effects of primary surgery. Objectives, The objective of this review was to systematically assess and collate all available evidence on effectiveness of primary brachial plexus surgery for infants with obstetric brachial plexus palsy. Search strategy, A systematic literature search was performed using 13 databases: TRIP, MEDLINE, CINAHL, Web of Science, Proquest 5000, Evidence Based Medicine Reviews, Expanded Academic ASAP, Meditext, Science Direct, the Physiotherapy Evidence Database, Proquest Digital Dissertations, Open Archives Initiative Search Engine, the Australian Digital Thesis program. Those studies that were reported in English and published between July 1992 to June 2004 were included in this review. Selection criteria, Quantitative studies that investigated the effectiveness of primary brachial plexus surgery for infants with obstetric brachial plexus palsy were eligible for inclusion into this review. This excluded studies where infants were solely managed conservatively or with pharmacological agents, or underwent surgery for the management of secondary deformities. Data collection and analysis, Two independent reviewers assessed the eligibility of each study for inclusion into the review, the study design used and its methodological quality. Where any disagreement occurred, consensus was reached by discussion. Studies were also assessed for clinical homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format. Results, Twenty-one studies were included in the review. Most were ranked low on the hierarchy of evidence (no randomised controlled trials were found), and most had only fair methodological quality. Surgical intervention was variable, as were the eligibility criteria for surgery, the timing of surgery and the outcome instruments used to evaluate the effect of surgery. Therefore, it is difficult to draw conclusions regarding the effectiveness of primary brachial plexus surgery for infants with obstetric brachial plexus palsy. Conclusions, Although there is a wealth of information regarding the outcome following primary brachial plexus surgery it was not possible to determine whether this treatment is effective in increasing functional recovery in infants with obstetric brachial plexus palsy. Further research is required to develop standardised surgical criteria, and standardised outcome measures should be used at specific points in time during the recovery process to facilitate comparison between studies. Moreover, comparison groups are required to determine the relative effectiveness of surgery compared with other forms of management. [source] A12. IPL therapy in the inflammatory stage of rosaceaJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2002M Rone The inflammatory stage of Rosacea iscommonly treated with topical or oral antibiotics. However, if additional erythema and telangiectasias are present, antibiotics are not successful. IPL (intense pulsed light) is mostly involved when only initial or residual telangiectasias are present. Application of IPL simultaneously with topical or oral medicine could be an effective form of treatment in the inflammatory stage of rosacea. This study was performed in order to detect the effect of IPL application with simultaneous topical antibiotics in inflammatory rosacea and to assess the efficacy of IPL therapy in routine treatment of rosacea. Twenty patients aged between 34 and 70 with papulopustular rosacea (14 female and 7 male) were included in the study. Ten patients (group I) were treated for 21 weeks with topical metronidazole. The other ten patients (group II) received an additional 3 sessions with IPL 515,755 nm Photoderm VL technology over 4 weeks. Treatment affectivity was recorded by digital visualisation and patient satisfaction scale before each IPL session. In all patients, significant reductions in papulopustular elements were observed. Eight out of 10 patients (group I) still showed permanent erythema and telangiectasias despite topical treatment. In 3/10 patients a few telangiectasias remained following the treatment in contrast to 5/10 satisfied group I patients. The most effective treatment was the application of 570 nm and 590 nm wavelength at a fluence of 25,55 J/cm2. Application of IPL in inflammatory rosacea is equally as safe and effective in residual or initial lesions. Moreover, in combination with antibiotics, it promotes reduction of all symptoms, is less time-consuming and is more successful for patients. The pathogenetic influence of IPL in rosacea seems not only to be limited to selective photothermolysis of dilated blood vessels, but may also have immunomodulatory effects on inflammatory processes and possibly on collagen remodelling. The combination of IPL and antibiotics from theoutset of rosacea therapy is considered to be highly effective. [source] Factors predicting success of endoscopic variceal ligation for secondary prophylaxis of esophageal variceal bleedingJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2006Gavin C Harewood Abstract Introduction:, Endoscopic obliteration of esophageal varices by endoscopic variceal ligation (EVL) is an effective form of secondary prophylaxis. However, there is no consensus regarding the technical aspects of EVL for secondary prophylaxis. The present study compares the technical aspects of EVL (frequency of sessions, number of sessions and number of bands used) in patients who rebled following secondary prophylaxis of esophageal varices by EVL compared to those who did not rebleed. Methods:, All patients who underwent EVL for treatment of acute variceal bleeding followed by EVL for secondary prophylaxis and who subsequently developed recurrent variceal bleeding at Mayo Clinic, Rochester between January 1995 and May 2003 were identified. A control group of patients undergoing EVL for secondary prophylaxis who did not rebleed was identified. Results:, During the study period, 216 patients with acute esophageal variceal hemorrhage underwent emergent EVL treatment with follow-up EVL for secondary prophylaxis, of whom 20 (9.3%) subsequently rebled. Both rebleeding and non-rebleeding patient groups were well-matched with respect to liver function (Child,Pugh class), number and size of variceal trunks, endoscopic stigmata of hemorrhage and beta-blocker usage. The median interval between EVL sessions in the rebleeding group (2 weeks, interquartile range 0,2 weeks) was significantly shorter compared to the non-rebleeding group (5 weeks, interquartile range 3,7 weeks; P = 0.004). Adjusting for age, gender, and Child,Pugh class, interbanding interval , 3 weeks was associated with increased likelihood of not rebleeding, hazard ratio 3.84 (95% confidence interval: 1.69,11.79; P = 0.0007). Conclusions:, These findings demonstrate the importance of technical aspects of EVL on patient outcome, suggesting the benefit of longer interbanding intervals. Future prospective studies are required to define the optimal intersession interval. Standardizing procedural aspects of EVL will aid in objectively evaluating the benefit of this procedure when compared to other modalities such as medical treatment. [source] Equipment donation to developing countriesANAESTHESIA, Issue 2007A. R. Gatrad Summary Equipment donations to colleagues working in developing countries may be a very effective form of aid, provided that the items supplied follow international guidelines and are practical for the receiving unit. A number of predictable difficulties may arise during the process and this article demonstrates what can be achieved by a few enthusiastic volunteers. [source] Radioimmunotherapy of small-volume disease of metastatic colorectal cancerCANCER, Issue S4 2002Results of a phase II trial with the iodine-13, carcinoembryonic antigen antibody hMN-1, labeled humanized anti Abstract BACKGROUND Whereas radioimmunotherapy (RIT) has shown disappointing results in bulky, solid tumors, preclinical results in small-volume disease and in an adjuvant setting are promising. In a previous Phase I study, the authors had encouraging results with the iodine-131 (131I),labeled humanized anti,carcinoembryonic antigen (anti-CEA) antibody (MAb) hMN-14 in small-volume disease of colorectal cancer. The aim of this study was to evaluate, in a subsequent Phase II trial, the therapeutic efficacy of this 131I-labeled humanized anti-CEA antibody in colorectal cancer patients with small-volume disease or in an adjuvant setting. METHODS Thirty colorectal cancer patients, with small-volume metastatic disease (n = 21; all lesions , 3.0 cm, and chemorefractory to 5-fluorouracil and folinic acid) or in an adjuvant setting (n = 9), 4,6 weeks after surgical resection of liver metastases with curative intention, were studied. The patients were given a single injection of 131I-hMN-14 immunoglobulin G at a 60 mCi/m2 dose level, which was shown to be the maximum tolerated dose in the previous Phase I study. Follow-up was obtained at 3-month intervals for as long as 36 months. RESULTS At a mean blood-based red marrow dose of 1.8 ± 0.8 Gy, myelotoxicity was the only toxicity observed, but only 1 of 28 assessable patients developed transient Grade 4 thrombocytopenia. Of the 21 patients with radiologically documented lesions, 19 were assessable. Three experienced partial remission and eight showed minor responses up to 15 months in duration (corresponding to an objective response rate of 16% and an overall response rate of 58%; the mean duration of response was 9 months). At the time this article was written, seven of nine patients in the adjuvant setting had remained free of disease for up to 36 months (one patient relapsed after 6 months and another after 30 months), whereas the relapse rate in a historical control group receiving chemotherapy was 67% over the same time period. Five patients with radiologically documented lesions, having experienced at least disease stabilization as a consequence of RIT, were retreated at the same 60-mCi/m2 dose level at 8,16 months after the first therapy. No evidence of increased toxicity was observed (no hematologic toxicity was higher than Grade 3). Two of four assessable retreated patients experienced partial remissions; one of these four again experienced disease stabilization as a consequence of the second radioantibody therapy injection. CONCLUSIONS These data suggest that RIT is a safe and effective form of therapy for small-volume colorectal cancer and has potential as treatment for colorectal cancer in an adjuvant setting. Toxicity is restricted to mild and transient leuko- and thrombocytopenia. Retreatment seems to be a feasible option. A prospective randomized comparison with standard chemotherapy is indicated. Cancer 2002;94:1373,81. © 2002 American Cancer Society. DOI 10.1002/cncr.10308 [source] Psychological treatments for functional non-epileptic attacks: a systematic reviewACTA NEUROPSYCHIATRICA, Issue 4 2009Danielle Gaynor Objective: There is a lack of clarity about the most useful intervention for functional non-epileptic attacks (FNEA). Outcomes for this condition remain often poor, with considerable personal, social and economic impact. In order to guide clinical practice and future research in this area, we have performed a systematic review of the published literature on the psychological treatment of FNEA. Methods: A comprehensive literature search was carried out using key words: non-epileptic seizures; psychogenic seizures; psychogenic non-epileptic seizures; pseudoseizures; funny turns; non-epileptic attack; hysterical seizures; and pseudoepileptic. Studies specifically looking at psychological treatment of FNEA were identified. Studies of patients also having comorbid organic seizure disorders were excluded. Results: 17 studies that met the inclusion criteria were identified. A broad variety of psychological interventions for FNEA has been investigated. Only one randomised controlled trial has been completed to date. Existing evidence appears to suggest that various psychological treatments, including presenting the diagnosis, psychoeducation, behavioural therapies and mixed modality treatments, may be effective. Conclusion: While a range of psychological treatments may be beneficial for this patient group, we do not have clear evidence to suggest which treatment is most efficacious. Specific elements of presenting the diagnosis and psychoeducation may be required in addition to traditional cognitive behavioural therapeutic approaches. Large, methodologically robust studies are urgently required to establish the most effective form of treatment. [source] The parenting of young people: using newsletters to provide information and supportCHILDREN & SOCIETY, Issue 4 2005Julie Shepherd The literature shows that many parents of young people do not have enough information, advice, and support in bringing up their children. This article describes an innovative project, undertaken by the Trust for the Study of Adolescence (TSA), which evaluated the use of newsletters as a form of support for the parents of young people. Following consultation with parents and young people, four newsletters were produced in a ,magazine' style. The newsletters were distributed to over 4000 parents across the UK. An evaluation was undertaken, involving longitudinal interviews with 40 families and over 800 telephone interviews with parents. This showed the newsletters to be an effective form of information and support for the majority of parents. However, the results also highlighted a number of issues to be considered in using newsletters as a parenting intervention, including levels of literacy, English as an additional language, social class, and reaching fathers as well as mothers. [source] Genetics education in the nursing profession: literature reviewJOURNAL OF ADVANCED NURSING, Issue 2 2006Sarah Burke BA MA Aim., This paper reports a literature review exploring genetics education for nursing professionals. The aim was to contribute to the debate about the future direction of such education. Background., Advances in genetics science and technology have profound implications for health care and the growing importance and relevance of genetics for everyday nursing practice is increasingly recognized. Method., A search was conducted in February 2005 using the CINAHL and Google Scholar databases and the keywords nurse, midwife, health visitor, education and genetics. Papers were included if they were published in English between 1994 and 2005 and included empirical data about genetics education in nursing. In addition, attempts were made to access the grey literature, with requests for information on research, for example, to members of the Association of Genetic Nurses and Counsellors and searches of relevant websites. Findings., Agreement on the relevance of genetics for nursing practice is extensive. Empirical evidence of the learning needs of practitioners highlights widespread deficits in knowledge and skills, and low confidence levels. Provision of nursing education in genetics is patchy and insubstantial across a number of countries, further hampered by lack of strategic development. Significant progress has been made in the identification of learning outcomes for nurses. Research on the delivery of genetics education is limited, but the role of skills-based training, use of clinical scenarios, and importance of assessment have all been identified as factors that can promote learning. Conclusion., Whilst areas of good performance were revealed, many studies identified gaps in professional competence and/or education. New initiatives are underway to support genetics education and its integration into professional practice, but further research is needed on the most effective forms of educational delivery, and an international collaborative approach to this should be considered. [source] | ||||||||||